Midwifery Test Questions

Correct Answer: A

Rationale: The correct answer is A: Entonox. Entonox, a mixture of nitrous oxide and oxygen, is commonly used for inhalational analgesia during labor due to its fast-acting and safe properties. Nitrous oxide provides pain relief without affecting the baby's heart rate or causing sedation. Trilene (B) is not commonly used during labor due to potential side effects on the baby. Oxygen (C) is not an analgesic but is often used in conjunction with Entonox. Nitrous oxide (D) is the active component in Entonox and is the primary analgesic agent in this mixture.

Correct Answer: B

Rationale: The correct answer is B. Ordering hepatic ultrasound annually to follow progression is the appropriate response for hepatic hemangiomas. Biopsy is not recommended due to the risk of bleeding. Surgery is usually not required unless there are complications. Documenting the finding is important but does not address the need for monitoring. Ultrasound allows for non-invasive monitoring of the hemangiomas over time to assess for growth or complications, guiding further management if needed.

Correct Answer: A

Rationale: Rationale for correct answer (A): At 36 weeks, the baby has enough room to move, reducing risks of complications during external cephalic version. Earlier intervention also allows for possible repeat attempts if needed. This timing aligns with guidelines for optimal success rates. Summary of other choices: B: 38 weeks may be too late as the baby may have less space to turn. C: 42 weeks is post-term and poses risks for both the baby and the mother. D: 40 weeks is close to full term and may not allow for adequate time for successful version.

Correct Answer: C

Rationale: The correct answer is C: Place the client in knee-chest position. This helps relieve pressure on the cord and prevents further compression, ensuring adequate blood flow to the fetus. Pushing the cord back in (A) can worsen the situation. Covering the cord (B) does not address the urgent need to relieve pressure. Immediate vaginal delivery (D) may not be possible or safe at 32 weeks. Placing the client in the knee-chest position is the most immediate and effective action to manage cord prolapse.

Correct Answer: B

Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics. A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.